From John Yudkin to Jamie Oliver: a Short but Sweet History on the War Against Sugar
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95 7 From John Yudkin to Jamie Oliver: A Short but Sweet History on the War against Sugar Rachel Meach In 2016, an anti-sugar campaign headed by celebrity chef Jamie Oliver was launched in the United Kingdom. Dubbed a ‘crusade against sugar’, Oliver’s documentary Sugar Rush examined Britain’s penchant for sweetness, exposing the health implications of excessive consumption and calling on the British government to tax sugary drinks in order to reduce obesity and diet-related diseases. 1 In the midst of the furore that ensued, the National Obesity Forum (NOF) and the Public Health Collaboration (PHC) published a report, which demanded a major overhaul of offi cial dietary guidelines. Th e report condemned the dietary doctrine of ‘low fat’, which had dominated offi cial dietary guidelines in the United Kingdom since 1983, alleging the advice was based on ‘fl awed science’ which had failed to curb rates of obesity and type 2 diabetes. 2 Th eir call intensifi ed the debate even further; while members of the PHC described low- fat guidelines as ‘the biggest mistake in modern medical history’, others warned that reversing the current guidelines may prove disastrous for public health. 3 Central in this debate was the concern that by buying into the ‘low-fat’ ideology, people unknowingly increased their consumption of refi ned sugar as a result. As the food industry had replaced fat with sugar in many of its ‘low-fat’ products, nutritionists and the public alike began to question whether it was not fat aft er all, but sugar, fuelling the epidemic of chronic disease. 4 Consequently, a war of nutritional ideology between fat and sugar, fi rst waged in the 1950s, has re-emerged in an attempt to solve the enigma of diet-related disease. Th e idea that sugar consumption could be potentially detrimental to health is not a new one. Towards the end of the 1950s, heightened fears of coronary heart disease fuelled a search for the dietary components responsible for the dramatic rise in cardiovascular mortality and other diet-related diseases. During the surge in nutrition research that followed, nutritionists polarized into two distinct groups. One group followed American nutritionist Ancel Keys and believed that dietary fat was to blame; the other concurred with the views of British nutritionist John Yudkin that carbohydrates, primarily refi ned sugar, was responsible. In the decades that saw heart diseases accelerate, sugar consumption rose in parallel, increasing sevenfold since 1900. 5 Nevertheless, as evident in the dominance of ‘low-fat’ dietary recommendations 99781350056862_pi-248.indd781350056862_pi-248.indd 9955 005-Oct-185-Oct-18 55:35:00:35:00 PPMM 96 96 Proteins, Pathologies and Politics that followed, Keys and his critique of fat won the debate and Yudkin’s warnings about sugar lay dormant until recent years. Th is chapter explores the development of the diet-heart debate, analysing how ideas about diet and disease were disseminated to the public and the role they played in shaping offi cial dietary guidelines and nutritional discourses in both Britain and the United States. Th e chapter begins with a historical overview of the link between sugar and disease before moving on to analyse the diet- heart debate in more detail, focusing in particular on the publications of John Yudkin, the late British nutritionist, renowned for his ‘prophecy’ on the dangers of sugar. 6 Th is section examines a range of Yudkin’s works but specifi cally addresses his series of diet and weight loss books published during the 1950s to 1980s which sought to promote a low-carbohydrate diet before moving on to assess the impact Yudkin’s warning had on twentieth-century dietary guidelines. Th e following chapter thus sheds light on the social, political and cultural factors that infl uence our notions of the ideal diet, reappraising the views of John Yudkin; it attempts to understand why his warnings about sugar were ultimately dismissed. Sugar’s place at the table Sugar fi rst made its way to England in the twelft h century and what little quantities arrived were typically reserved for the wealthy. Over the next fi ve centuries, its availability increased slowly until around 1650 when the modernization and expansion of refi neries allowed for greater production. According to historian Sidney Mintz, it was here that ‘sugar began to change from a luxury and rarity to a commonplace necessity’. 7 Mass production and cheap labour lowered the price of sugar and it quickly found its place as a cheap source of energy within the diets of the working class. As a commodity only aff orded by the rich, sugar was held in high esteem and its whiteness was seen to symbolize its purity, healthfulness and superiority over other sweeteners. 8 However, as the price of sugar declined, and thus became widely consumed, ideas about sugar and its nutritional status were challenged. Both historians, the medical professionals and epidemiologists alike maintain that the link between sugar consumption and chronic disease has corresponded with its development and increased presence in Western diets. Denis Parson Burkitt, the late surgeon renowned for his work on cancer and nutrition, remarked of the association between refi ned carbohydrate and disease that the ‘fear that sugar may be injurious is as old as the written history of this sweet food’. 9 Burkitt traced concerns surrounding sugar’s nutritional value to India around 100 AD when soon aft er the cultivation and importation of sugar cane from New Guinea, Charake Samhita ascribed both obesity and diabetes to this ‘new article of diet’. 10 In the twentieth century, American investigators Emerson and Larimore (1924), having traced the reported rise in diabetic mortality in New York since 1866, ascribed their fi ndings to changes in dietary habits, especially the rise in sugar consumption. Emerson and Larimore were the fi rst to draw a defi nite correlation between the infl uence of social and environmental factors such as diet and the incidental rise of diabetes. 11 Similarly in Britain, Stocks (1944), 99781350056862_pi-248.indd781350056862_pi-248.indd 9966 005-Oct-185-Oct-18 55:35:00:35:00 PPMM 97 From John Yudkin to Jamie Oliver 97 having studied the increase in diabetic mortality in England and Wales from 1861 to 1942, drew attention to the marked decline in diabetic mortality during the two world wars; this he believed was due to wartime rationing and reduced consumption of sugar. Th ese fi ndings, along with those of Himsworth (1949) were reassessed further by British surgeon Th omas Cleave in his book Th e Saccharine Disease (1974). A keen purveyor of the damaging health consequences of sugar consumption, Cleave drew a convincing link between the decline in sugar consumption during both world wars and the corresponding decline in diabetes mortality and the overconsumption of refi ned carbohydrates, notably sugar and fl our, and the increase in many prevalent chronic diseases. Yet, despite this periodic connection between sugar consumption and disease, no other fi gure generated such controversy over sugar as the late British nutritionist John Yudkin. In a series of publications written during the 1950s to 1980s, Yudkin maintained that a host of chronic conditions, from diabetes, obesity and heart disease, to asthma, dermatitis and Crohn’s disease, could be attributed to high consumption of sucrose. At the height of the diet-heart debate, Yudkin argued against the nutritional consensus of the time, stating that it was not fat, but sugar that was fuelling the post-war rise in cardiovascular mortality and many other chronic diseases. A war of nutritional ideology Th e emergence of the diet-heart debate at the end of the 1950s has been well documented. 12 Yet among these accounts, consideration of the context in which the debate emerged has oft en been overlooked. Beginning in the 1950s, as the manufactured-food industry expanded, refi ned sugar had found its place as a crucial ingredient in a range of new foods and was vital in creating the image, particularly in the United States, of a consumer paradise with an abundance of ready-made, convenience foods. Yet, as sugar was being added to an increasing range of foods, rates of diabetes, obesity and heart disease were quietly escalating. As a MetLife study published in the New York Times in 1951 revealed, body fat had become America’s ‘primary public health problem’. 13 Th is anxiety regarding the relationship between diet and disease was heightened further in 1952 when the US president Eisenhower suff ered a heart attack, an event which thrust the issue into the public domain. By the end of the 1960s, a war of nutritional ideology was in full swing, symbolized by a polarized debate between two eminent nutrition scientists. In 1958, nutrition scientist Ancel Keys launched his Seven Countries Study, a major survey of the potential risk factors of cardiovascular disease. Keys asserted that fat was to blame for the rise in heart disease and only a diet low in fat would lower cholesterol and reverse the intensifying trend fast becoming prevalent across most of the Western world. 14 Around the same time, British nutritionist John Yudkin found that sugar too appeared to correlate with heart disease in several countries and thus put forth his contending hypothesis that high sugar consumption was a key cause of heart disease. Initially, Yudkin seemed more agreeable to the idea that both fat 99781350056862_pi-248.indd781350056862_pi-248.indd 9977 005-Oct-185-Oct-18 55:35:00:35:00 PPMM 98 98 Proteins, Pathologies and Politics and sugar were somehow implicated as mutually confounding variables, present in equally high levels in the diets of those he had observed.